Close contact with each other in daily life and sexual life can infect hepatitis B.

What are the main transmission routes of hepatitis B?

(1) blood-borne transmission: if whole blood, plasma, serum or other blood products are imported, it will be transmitted through blood-borne injection. (2) Fetal transmission: if pregnant women carry the virus, it will spread vertically to newborns through the birth canal; Fetal infection of pregnant women with hepatitis in the third trimester of pregnancy. (3) Iatrogenic transmission: If medical devices are not thoroughly disinfected or improperly treated after being contaminated by hepatitis B virus, it can cause transmission; It is also one of the ways to prevent iatrogenic transmission when injecting several people with 1 syringes; Hemodialysis patients are the targets of hepatitis B transmission. (4) Sexual contact transmission: In recent years, the observation of foreign reports on promiscuity, homosexuality and heterogamy affirmed that the sexual transmission of hepatitis B is an important way of sexual partner infection, which also includes the transmission between husband and wife in the family. (5) Insect bite transmission: mosquitoes and blood-sucking insects in the tropics and subtropics may play a role in the transmission of hepatitis B.. (6) Close contact and transmission in life: Long-term close contact with hepatitis B patients or virus carriers, saliva, urine, blood, gallbladder and milk can pollute utensils and articles, and spread hepatitis B through damaged skin and mucosa.

Can hepatitis patients get married?

doctor: oh, you are going to plan a lifelong event. I wonder how your illness has been in recent years.

patient: three years ago, I found out that I had hepatitis, and I took the medicine for a few months. The doctor said that the blood test showed that my liver function returned to normal, and I was positive for HBsAg and hepatitis E antigen. I will check it every six months, and the results are all the same. Can I get married?

Doctor: Patients with hepatitis can get married if their symptoms disappear and their liver function is normal and remain stable for more than one year. Getting married when hepatitis has not recovered may aggravate the condition. The marriage of HBsAg-positive people is generally unaffected, but considering that the chances of transmitting hepatitis to spouses after marriage have increased, some preventive measures should be taken to avoid infection.

Patient: Will getting married make hepatitis worse?

doctor: yes. On the one hand, it is because some young people are excited about the wedding, and they are too tired because of shopping, decorating their houses and socializing frequently; Some people have stopped drinking for many years because of hepatitis, and people can't stand the temptation to quit drinking at every happy occasion, which will make hepatitis relapse or aggravate their condition. On the other hand, newlyweds and those who have suffered from hepatitis should also pay attention to sexual abstinence.

Patient: Doctor, we need this knowledge very much. Please introduce it to us.

Doctor: Normal and moderate sexual life is a physiological requirement of human body. Patients in the recovery period of hepatitis can also do it according to their own health conditions, but they should be restrained. Sexual life is a special physical and mental activity. Both sexual organs and cerebral cortex of the couple are in a state of high excitement. Sexual life consumes certain physical strength, which will increase blood pressure, shortness of breath, accelerate pulse and cause liver ischemia and hypoxia. If sexual life is not controlled, it may lead to aggravation of the disease. The so-called abstinence, because sexual life is based on the health of both husband and wife, people's sexual desire requirements are also very different, it is difficult to put forward the appropriate standard of how many times a week, in short, we must do what we can.

2. How does the spouse avoid infecting the sick

: My boyfriend proposed to get married a year ago, but I heard that hepatitis B is very contagious and will pass it on to him after marriage. I love him and don't want to hurt him, so my heart is full of contradictions and pains.

doctor: after marriage, the close daily contact and sexual life of both parties will infect hepatitis B, but there is a good way to prevent it, and that is to inject hepatitis B vaccine. Before marriage, the other party should also take blood to test whether they have been infected with hepatitis B virus. There are three kinds of results: ① The other party is HBsAg negative, which means that it has never been infected, so it is necessary to inject hepatitis B vaccine first. You can get married with confidence when you are resistant to hepatitis B, that is, you are positive for anti-－HBs. ② The test result of the other party is positive for anti-－HBs, which means that it has already been resistant to hepatitis B, so there is no need to inject hepatitis B vaccine, so there is no need to worry about getting married; (3) If the other party is also HBsAg positive, there is no problem of mutual infection between the two parties, and marriage is naturally unrestricted.

Patient: My boyfriend had a blood test not long ago, and the doctor said that he would take hepatitis B vaccine. How should I use it?

Doctor: Hepatitis B vaccine requires three injections, and the second and third injections are given in October and June after the first injection.

Patient: Why do you need three shots of hepatitis B vaccine?

Doctor: Because the hepatitis B vaccine used in China is a inactivated blood source vaccine, only one injection can not produce enough immune protection. According to our research data, more than 95% teenagers and adults can have immunity by using three full needles according to regulations. Medically, the first and second doses of vaccine are called sensitization vaccination, which makes the vaccinator produce antibodies, and the third dose is called strengthening immunity, which makes the antibody titer higher and the preventive effect more lasting.

3. How to treat the patients with contraception and childbirth after marriage

Recently, due to busy work and study tasks, I don't want to have children for the time being. What contraceptive method should I use?

Doctor: Oral contraceptives have been widely used by women in China. These drugs, whether short-acting or long-acting, are safe and effective, and only long-term or large-scale use will have side effects on the liver in very few people. As you have suffered from hepatitis, it is not appropriate to use drugs for contraception. Other contraceptive methods, such as condoms, should be used instead.

Patient: Can a woman with hepatitis B have children?

Doctor: The patient with hepatitis is not stable, and the liver function has not returned to normal, so it is not suitable for pregnancy, which is related to both mother and child. Pregnancy and childbirth will increase the burden on the liver, make the condition worse, and may cause miscarriage, premature delivery and stillbirth. Therefore, it is advisable to give birth after symptoms disappear and liver function is normal for more than 1 years.

Patient: I have a girlfriend who got viral hepatitis when she was 4 months pregnant. Some doctors said that the fetus would be deformed. Is it really so terrible?

doctor: it is generally believed that hepatitis virus may affect the fetus in the early pregnancy (within 3 ~ 4 months), but it will not be affected in the late pregnancy. Some scholars have made a detailed and extensive investigation and five-year follow-up observation on pregnant women with viral hepatitis, and found no causal relationship between hepatitis during pregnancy and fetal congenital malformation. Therefore, tell your girlfriend, including yourself, not to worry too much, and the doctor will give you guidance during the prenatal examination.

Patient: However, this doctor wants my girlfriend to have an abortion. Should she do it?

doctor: as I said above, pregnant women who have hepatitis, or pregnant women who have hepatitis, have different degrees of adverse effects on the fetus and pregnant women, and terminating pregnancy surgery may not improve the hepatitis process, but sometimes it will aggravate the condition. Therefore, it is generally not recommended that pregnant women suffering from hepatitis use induced abortion and other operations to terminate pregnancy. They should actively treat hepatitis, strengthen monitoring and let them give birth naturally. In this regard, experienced doctors should make medical advice according to the specific situation of each patient.

4. How to avoid transmission to the fetus

Patient: If a HBsAg positive person like me is pregnant, will it be transmitted to the fetus?

doctor: this question is exactly what I want to talk about. Hepatitis B virus can be transmitted from mother to fetus. According to statistics, about half of babies born to HBsAg-positive mothers are infected within one year. If the mother is E antigen-positive, the proportion of infection will be higher, but most of them are infected during childbirth and in close contact with the mother and baby after childbirth, and a few are infected through the placenta. The former can be blocked by injecting hepatitis B vaccine.

Patient: How to use the hepatitis B vaccine?

Doctor: Hepatitis B vaccine should be injected within 24 hours after the baby is born, one at 1 months old and one at 6 months old, and all three injections are 31 micrograms. The effect is very good, and the protective effect of newborns can reach 91%. If one injection (1 ml) of hepatitis B high titer immunoglobulin (HBIG) is injected within 6 hours after birth, and then the hepatitis B vaccine is injected at 1, 2 and 7 months after birth, the protective effect can reach 95%. Because a few (about 11%) fetuses are infected in uterus through placenta, preventive injection after birth is ineffective.

Patient: Is there any way to block the transmission of hepatitis B in the uterus?

doctor: this is a subject that medical scientists have been painstakingly studying for many years. Recently, Shanghai Medical University has achieved initial results. Their method is to inject an injection of HBIG once a month three months before delivery and three times before delivery. The effect is obvious. Compared with other newborns born to pregnant women with hepatitis B virus, the infection rate of hepatitis B virus in uterus is reduced by nearly 2/3. The research results have been appraised by the relevant expert group of the Ministry of Health, and qualified units can try it out.

5. What is the influence of sick parents on their children?

Patient: Does the father's hepatitis B have a great influence on his children?

doctor: at present, there is no definite data that hepatitis can be inherited, so it is still believed that the father with hepatitis has a close contact with his children in daily life. Recently, it has been reported that hepatitis B virus was found in sperm, and it is estimated that there is also father-infant transmission. If the father has hepatitis B, his children should also pay attention to the injection of hepatitis B vaccine. Newborns can get better results by injecting HBIG first.

Patient: Can HBsAg positive mothers breastfeed their babies?

Doctor: HBsAg can also be detected in the milk of HBsAg-positive mothers, so breastfeeding can transmit hepatitis to babies. However, since breast milk is not the main route of transmission of hepatitis B, its risk is far less than blood. If the baby has been injected with HBIG and hepatitis B vaccine according to the above requirements, breast-feeding is also optional. In addition, it should also be noted that lactating mothers need to secrete a lot of milk every day, which requires a lot of nutrition and calories. If pregnant women with hepatitis have poor appetite and insufficient nutrition, their condition will be aggravated. Therefore, whether to breastfeed should be considered from both mother and baby.

Patient: Can HBsAg carriers have sex? What should they pay attention to?

Doctor: If one of the husband and wife is a carrier of hepatitis B surface antigen, those who are generally in good condition and have normal liver function can have a normal sexual life, but they should pay attention to the hygiene of sexual life to prevent hepatitis B virus from being transmitted to their spouses. If the spouse has self-protection ability (that is, anti -HBs positive), he can have sex like a normal person; If both HBsAg and anti -HBs are negative, hepatitis B vaccine should be injected as soon as possible to produce antibodies. It is best to use condoms during sexual life before your spouse is vaccinated against hepatitis B.

Patient: Can you be infected by working with carriers of hepatitis B surface antigen?

doctor: because hepatitis b virus is mainly transmitted through blood and body fluids, the probability of transmission through digestive tract is very low, and the probability of transmission of hepatitis b virus through indirect contact is even lower. Healthy people work with HBsAg carriers, although they can use desks, chairs, doors, windows, telephones and writing tools, but they are all indirectly contacted and generally will not be infected. Only the tableware and washing utensils of HBsAg carriers should be used alone, and should not be mixed with others.

Is the person with positive HBsAg contagious and can he get married?

There are many indicators reflecting the replication of hepatitis B virus, such as HBsAg, HBV-DNA, anti -HBclgM, etc. The simplest and cheapest way is to check the five indicators of hepatitis B.. If HBsAg, HBeAg and anti-HBc are positive (that is, big three positive), its blood is highly contagious; If anti -HBe is positive, its blood is less contagious.

Generally speaking, HBsAg positive people can participate in work, study and social activities like normal people, and they pose no obvious threat to the comrades around them. It is best for HBsAg positive carriers to check their HBeAg and anti -HBe before getting married. If anti -HBe is positive, it means that they are less contagious and can get married. If H BeAg is positive, it is necessary to check the other person's serum again. If it is anti -HBs positive, it means that the other person is immune to hepatitis B virus and will not be infected again. If the other party's HBsAg, anti -HBs and anti -HBc are all negative, you can inject inactivated hepatitis B virus vaccine and get married after the protective antibody is produced in the body.

The mother is a carrier of hepatitis B virus (HBV). What should I do if the baby is infected with HBV in utero?

Mother-to-child transmission of HBV is the main mode of chronic HBV infection. If effective measures are not taken, almost all babies born to mothers with HBsAg and HBeAg will be infected with HBV, and 95% of them will become chronic carriers, and chronic HBV infection will lead to cirrhosis and liver cancer when they reach adulthood. Infants infected with intrauterine HBV have developed immune tolerance to HBV antigens at the level of T lymphocytes, but this tolerance is mostly incomplete, so it is mostly effective to immunize them with hepatitis B vaccine in time after birth. Preventive measures: Give hepatitis B immunoglobulin (HBIG) 1 ml within 48 hours after birth (>; 211Iu/ml) intramuscular injection, the second HBIG treatment at 2 months after birth, and subcutaneous injection of 11μg hepatitis B vaccine at 2, 3 and 5 months after birth can greatly reduce the positive rate of HBsAg. According to research reports, hepatitis B vaccine can provide protection for infants born to HBeAg positive mothers for at least 11 years, so it is not necessary to carry out routine intensive immunization before the age of 11.

What is the long-term effect of neonatal hepatitis B vaccine immunization?

The level of anti -HBs produced after immunization with hepatitis B vaccine decreases with age or is not detected, which does not mean that the protection disappears. When infected with HBV, it can cause effective anti -HBs recall reaction (investigation shows that people who have no immune response or low immune response at the time of initial immunization may still have HBV infection, but the risk of low immune response is much lower than that of those who have no immune response). Hepatitis B vaccine is widely used in newborns, which can control the spread of hepatitis B virus in one generation in China. The key is to improve the immunization rate. After routine vaccination of hepatitis B vaccine in newborns, it is not necessary to strengthen immunization for at least 9 years, and the vaccine protection rate is above 85% in 1 ~ 9 years.

how to prevent infection when there are hepatitis patients at home?

preventive measures should be taken to prevent the spread of hepatitis among family members after someone in the family suffers from hepatitis. First of all, patients should be sent to the hospital for isolation treatment, and those who cannot be hospitalized for the time being should be treated at home for isolation treatment. The second is to cut off the route of transmission. The specific methods are as follows: ① Isolate patients. (2) share meals with hepatitis patients, use tableware alone, boil it alone for 31 minutes after use, and wash it for later use. The food left by the patient should be boiled and disinfected before being discarded. (3) the patient's special toilet, the patient's feces and excreta should be thoroughly disinfected. ④ The underwear, underpants and sheets changed by patients should be boiled for 1.5 minutes, or soaked in 1.2% 84 disinfectant for 21 minutes, then washed with soap and rinsed with clear water. ⑤ Items used by patients can also be soaked and disinfected with 84 disinfectant. 6. Patients or their families who care for patients should form the habit of washing their hands before and after meals, and wash their hands after contact with dirt.

Should all the family contacts of acute hepatitis B virus infected people be injected with hepatitis B vaccine?

If the mother and nanny suffer from acute hepatitis B, then the infants under the age of 1.2 months should be injected with hepatitis B high titer immunoglobulin, and at the same time, the hepatitis B vaccine should be vaccinated for 1, 1 and 6 times. It is effective for the father of the baby to inject hepatitis B immunoglobulin to prevent infection after sexual contact with his lover. Non-explicit contact with patients